Osteoarthritis

Symptoms   Causes   Self help   Nutritional discussion   Lifestyle   Integrative therapies

Osteoarthritis (OA) is a common degenerative condition of the joints, leading to pain and decreased mobility. It is associated with aging and injury (it used to be called "wear and tear" arthritis).

There are a number of proactive steps one can take naturally to help reduce pain associated with osteoarthritis.

Symptoms

OA most often affects the spine, knees, hips, knees, and fingers, or sometimes other joints. It's onset is gradual. Patients notice pain that gets worse with exercise and lessens with rest. Patients also report stiffness in the morning that gets better with some movements. However, As osteoarthritis progresses, joint motion is diminished more and more while grating sensations and tenderness may appear and/or get worse. Shooting pain down legs or arms may result from the condition in the spine. Rheumatoid Arthritis, on the other hand is characterized by morning pain and stiffness which tends to improve as the day continues.

Causes

Nearly half of all Americans older than 60 develop osteoarthritis and most people older than 80 will develop it. The percentage of people with osteoarthritis in Canada is even higher. But joints don't just wear out with age. Researchers now recognize that several factors lead to the development of osteoarthritis rather than one single factor. These are:

• biological factors
• age
• joint damage by injury
• joint damage by chronic obesity
• heredity

Conventional Treatment

Symptom relief is the primary treatment and includes use of soaking in hot water, application of warm wax, heating pads, and devices to support the joints. Pain medications include acetaminophen, nonsteroidal anti-inflammatory drugs, etodolac, ibuprofen, indomethacin, and others). Topical cream applications with capsaicin are also recommended for temporary pain relief.

Herbs & supplements that may be helpful

• Olive leaf extract has a strong antioxidant and anti-inflammatory capacity.
• New Zealand green-lipped mussel May help some people, there's a lot of possibly weak evidence.
• DMSO: Topical; under a doctor's supervision only.
• Cetyl myristoleate (CMO): 540 mg per day orally for 30 days.
• Ginger (Zingiber officinale): Ginger has historically been used for arthritis and rheumatism. Both a preliminary trial and a more recent double-blind trial found ginger extract (170 mg three times a day for three weeks) to be slightly more effective than a placebo.
• Nettle (Urtica dioica): Stinging nettle has traditionally been used for joint pain. Applying nettle to the skin to relieve joint pain appears to be safe and effective.
• White willow (Salix alba) (100 mg of the active ingredient, salicin, per day): White willow has anti-inflammatory and pain-relieving effects. Although the analgesic actions of willow are typically slow-acting, they tend to last longer than aspirin.
• Other herbs

Lifestyle

Obesity

Being overweight puts unusual stress on weight-bearing joints and increases osteoarthritis risk. Losing weight (in women) has been found to lower this risk^{5 6} and reduce OA pain.⁷ Furthermore, in obese patients who require joint replacement surgery, while the risk of wound-infection is greater, overall complications are not more likely.

Integrative Therapies

Acupuncture

Research into use of acupuncture to reduce osteoarthritis pain has yielded mixed results - comparing acupuncture to placebo or sham acupuncture. ^{100, 101} Subsequent research has shown marked positive results.^{102, 103} In one well-designed trial, 8 weeks of 2 times a week acupuncture treatment produced significant benefits in pain relief and increased mobility for patients with knee OA - compared to no treatment. ¹⁰⁴ And when the no-treatment group began to receive acupuncture treatment they had similar positive results.

Exercise & Physical Therapy

A controlled trial demonstrated that manual physical therapy (by an experienced physical therapist) and supervised exercise markedly reduced pain and increased walking ability and distance in OA knee patients.¹⁰⁵ The therapy included manual therapy to the ankle, knee, hip and low back and a standard exercise program for the knees to be done both at home and within the clinic. Patients received clinic treatment 2 times weekly for 4 weeks.

Recent research determined that mild exercise, in this case, yoga, showed therapeutic benefits and was manageable, doable, and safe for older women (mean age of 72) with osteoarthritis of the knee. The study involved 36 women in an 8 week yoga intervention program that was developed by 8 experts especially to address their knee osteoarthritis.¹⁰⁷

Other research addressed the pain of 156 patients with severe osteoarthritis. They were mostly women, average age 67, with a BMI of 30 and were scheduled for hip or knee replacement. Compared to controls, there were statistically significant differences in those who did a two times a week neuromuscular exercise program which was supervised by a physical therapist. The results were small for knee osteoarthritis, but moderate in hip osteoarthritis. Improvement was noted in standard performance tests such as walk, chair stands, and 1 leg knee bends.¹⁰⁸

Arthritis News

Want to learn more? See our blog news on osteoarthritis.

Studies

See footnotes and other research.

Additional footnotes

106. The effect of body mass index on the risk of post-operative complications during the 6 months following total hip replacement or total knee replacement surgery, Wallace, G., et al, Osteoarthritis Cartilage, May 2014.
107. Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial, Cheung C., et al, BMC Complementary and Alternative Medicine, May 2014, 14(1).
108. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee: A Secondary Analysis from a Randomized Controlled Trial, Viladsen, A., et al, Journal of Rheumatology, June 2014.

Symptoms   Causes   Self help   Nutritional discussion   Lifestyle   Integrative therapies